Quality Assurance Audit Manager

Consolidated Health Plans, Inc. is a Berkshire Hathaway company with an impressive record of growth.  CHP was established in 1993 as a Preferred Provider Organization (PPO) and Third Party Administrator (TPA) and is headquartered in Springfield, Massachusetts. Our mission is to provide superior insurance solutions by being accessible, responsive and flexible.  CHP offers competitive compensation and benefits packages.  Currently, we are seeking qualified applicants for Quality Assurance Audit Manager.   

Qualifications: 

  • Have 7+ years of work experience in audit, quality assurance or data analysis in health insurance or health care industry.
  • Have 5+ years of experience leading and managing a team of direct reports
  • Be analytical with advanced Excel proficiency and data analysis skills
  • Have excellent skills in following areas: organization, communication, process improvement
  • Bachelor’s degree or equivalent experience
  • Ability to work independently, with limited required direction and guidance
  • Detailed oriented, well organized, diligent, and methodical
  • Be proficient with MS Office products to include Excel, Outlook, Access, and Word; Visio, Project, SharePoint and PowerPoint are a plus.
  • Understanding of internal auditing standards and risk assessment practices
  • Experience and understanding of the application of business management, accounting and auditing  principles

Preferred experience:

  • Experience with: SSAE-16, SOC1, SOC2, ISO-9001
  • Experience in quality improvement with Six Sigma and/or Lean certification

Essential Responsibilities and Job Duties:

  • Set direction for, and manage the efforts of a team of auditors and Quality analysts
  • Develop and perform QA testing against business requirements, for application development and customer reporting
  • Work with operational leaders on Quality/Continuous Improvement initiatives: assess defect root cause; improve and standardize process
  • Structure and perform audit engagements for third party health insurance administrative partners (TPA)
  • Review and evaluate policies and procedures
  • Support fully-insured carrier audit reviews of company TPA
  • Other duties as required.

 

Reports to: Director of Quality Assurance   

 

Please send your resume and completed application to CHP Human Resources at:

Mail: Consolidated Health Plans, Human Resources, 2077 Roosevelt Avenue, Springfield, MA 01104-3503

Fax: (413) 452-5329 Attn. Human Resources

Email: human_resources@consolidatedhealthplan.com

Phone: (413) 733-4540 ext. 120

 

Employment Application

Download Employment Application

 

For more information contact us at human_resources@consolidatedhealthplan.com or call us at (413) 733-4540 ext. 120